Has Your Medical Bill Been Denied by Insurance? Try These Strategies
Has Your Medical Bill Been Denied by Insurance?
Do
you have medical bills that your insurance company doesn’t want to pay? You
have several options as you explore different ways to pay the bills.
If your insurance
company won’t pay the bill, consider these ideas:
1.
Understand the
out-of-network rules. Receiving care
out-of-network is one of the most common reasons an insurance company denies
payment.
·
Did
you go to a hospital, clinic, or doctor who is outside of your network?
Insurance companies have strict rules for what they will cover. They may not
want to pay for hospitals or doctors who aren’t part of their network.
·
Unless
you had an emergency that couldn’t be treated at an in-network provider, you
may not be able to get the insurance company to pay.
·
Your
city or state may have specific rules that can force insurance companies to pay
for out-of-network services in emergency situations. However, you may still be
responsible for some of the charges.
2.
Negotiate your
payment. If
your insurance company won’t budge on the medical bills, you can try to
negotiate a payment with the hospital or doctor.
·
Depending
on your financial circumstances, you may be able to get a discount or payment
plan to help you. You may also qualify for a grant, financial assistance, or other
program.
3.
Consider
contacting local charities. If your medical bills are extremely high
and you can’t pay them, a local charity might be able to help.
·
Local
charities may have ideas for helping you raise the money. They may have
fundraisers or grants that can assist you with the bills.
4.
Check for mistakes.
It’s possible that an error prevented
your insurance company from paying the medical bills. It’s important to
double check the actual bills and contact the medical provider for help.
·
Hospitals
and doctors sometimes make billing mistakes. They may bill the wrong insurance
company or send the wrong codes.
·
You
may want to contact both the doctor and insurance company multiple times if you
have questions about the bills. You have to become your own advocate and try to
get the bills covered.
5.
File an official
dispute. Your
insurance company should have an official dispute process. It may take a
mountain of paperwork and an ocean of phone calls, but you can handle the
dispute process.
·
Documentation is the key to winning a dispute. Keep careful
records and make multiple copies of each medical document. Find policy and
state rules that back up your claims.
6.
Make phone calls
and write letters. Experts
recommend doing both for the maximum effect and response rate.
·
Phone
calls may not be enough to get the attention of your insurance company.
·
You
may have to write letters or send faxes to document your issues. This
will create an important paper trail that can help your case.
7.
Consider getting a
medical billing advocate. These advocates can charge fees, but they can also
help you negotiate your bills and deal with insurance. If you have large
medical bills, then it may be worth the fee to get professional help.
·
Medical billing advocates are trained to help you pay
the smallest amount possible on your medical bills.
·
They
know the negotiation tactics that work on hospitals, doctors, and insurance
companies. They can handle the massive paperwork and calls that are required to
accomplish your goals.
Insurance
companies can deny payment for a variety of reasons. However, you have rights.
Before you pull out your checkbook, you may want to explore different ways to
handle the medical bills. Perhaps you can get them paid or reduced for your
time and trouble.
